Congenital Cutaneous Defects as Complications in Surviving Co-twins

Volkmann ischemic contracture in a newborn

“…In this case, as with most documented cases,1–16 sequelae are atrophy, scarring, mobility limitation and probable limitation of bone growth. The study by Ragland et al showed skeletal involvement in 18 cases and nerve lesions in 16 out of 24, with neurological recovery in four 9…”

“…The histological characteristics are unspecified and the necrosis severity is related to ischemia duration 4. In the cases previously described, there is no evidence of compression in other anatomical regions 1–16. However, in the present case a few discreet skin lesions were detected in other regions that may be related to slight compression from conflict of intrauterine compartment.…”

Aplasia Cutis Congenita of the Arm with Associated Radial Dysplasia: Case Report, Review of the Literature, and Proposed Classification

“…High compartmental pressure within the forearm leads to necrosis, scarring, and contracture. The authors concluded that this probably resulted from compression by the dead fetus . Prenatal ultrasounds in our case showed no evidence of twin pregnancy and no abnormalities, and placental examination showed no abnormalities.…”

Aplasia cutis congenita in surviving co-twin after propylthiouracil exposure in utero

“…Intra-uterine death of a twin may cause release of thrombotic material, promoting ACC in the surviving twin in the case of vascular shunts. This is usually associated with extensive placental infarctions, disseminated intravascular coagulation and other direct and usually severe injuries to the surviving twin, which we failed to fi nd in our index case (22,23) .…”